Few things get as much of a ticking-off as the tick-box culture. Newspaper jeremiads blame it for all that ails the NHS. Ken Clarke has grumbled about the "tick-box, bean-counting culture" that keeps prison officers from dealing with offenders. Everyone knows where tick-box sits in the political thesaurus: as a synonym for bureaucratic, pettifogging, obstructive ineffectuality. Well, perhaps the MPs and columnists should visit the cockpit of a plane or the operating theatres of a hospital to see just how useful a tick-box culture can be. Both pilots and surgeons routinely tick through exhaustive lists in preparation for their flights and operations. At the hospitals of University College London, the "surgical safety checklist" opens the batting with "Has the patient confirmed his/her identity"? A blindingly obvious question, maybe, but one where the wrong answer could prove fatal. This is how tick-boxes help: by keeping a team of professionals to a routine, minimising avoidable errors and allowing them to concentrate on the really important parts of the job. As surgeon and writer Atul Gawande argues, the paradoxical boon of a checklist is that it frees an expert – whether they're flying planes, slicing out an appendix or building a skyscraper – to show off their expertise. Research by the National Patient Safety Agency has shown that mere box-ticking can cut surgery-related deaths by over 40% and reduce complications by more than a third. Such stats should make you feel at least a bit kindlier to that clipboard.